Missy, Bill, and Katherine

Although Missy struggled with bouts of depression since childhood, she resisted taking medication. She finally sought treatment in order to be well for her infant daughter, Katherine.

At first the antidepressant helped, but then Missy became manic and was hospitalized. She continued to suffer for years, until her diagnosis was changed to bipolar disorder. To help Missy, Bill learned as much as he could about depression. Over time however, Bill developed a tic from stress and Bill and Missy drifted apart. Now, Missy is on new medication and is doing well. With couple's counseling and the support of their church and family, Bill and Missy are united and better than ever. Missy's personal account is included in Parenting Well When You're Depressed.

Missy

How were you diagnosed with bipolar disorder?

I'd been to therapists, on and off, since I was ten years old, but I wasn't diagnosed or taking medication. About nine years ago, I was caring for our daughter Katherine, who was about 18 months old. I wasn't feeling great, but I was functioning. I just felt like I was constantly encased in a black shroud. I realized that this was the only chance that I had to care for Katherine and enjoy her while she was little. Depression runs in my family, and both my sisters are on medication. My sisters really encouraged me to take medication.

So, I went a psychiatrist that I had seen a few times and she put me on an antidepressant. At first I felt great, but gradually I slipped into a manic episode. I had very high energy and stopped sleeping. I went from eight hours of sleep a night down to three hours of sleep. I wasn't even tired. My thoughts were racing, and I was going a million miles an hour. One night, I didn't sleep at all and reached a crisis. I felt like if I continued this way, then the only logic next step was suicide, because my life was intolerable. I sat up all night and waited until Bill could take me to the hospital.

After ten days in the hospital, they discharged me and referred me to a psychiatrist who I have been working with for nine years. At first I felt better, but over the next four years, I became much more depressed. Mood swings were so much a part of my life that I just resigned myself to being depressed.

Then, about three years ago, my psychiatrist started discussing irritable depression and how my moods are really unstable and shift quickly. He changed my diagnosis to atypical bipolar disorder and prescribed a new medication.

As time went on, Bill and I struggled with whether or not we should have a second child. A few years ago, we decided to go ahead. I wanted to go off my medication, even though my doctor strongly recommended against it. I didn't want to risk damage to the fetus and wanted to breast-feed. It was a terrible decision, because in the first trimester I went into the worst depression I've ever had. So, I went back on medication, and by the end of my pregnancy, I started to feel good. I've been doing well ever since.

What has made the difference?

The turning point was when my therapist changed my diagnosis to bipolar disorder and prescribed a mood stabilizer with an antipsychotic medication. The combination of the new medications, along with the joint counseling for Bill and I, plus support from our church and family, is what works.

What are your symptoms?

When I am not doing well, I feel irritable, overeat, lack concentration, and have a sense of hopelessness and anxiety. When I'm depressed, I feel tired and at my worst, I can't get out of bed. In a manic state, I have racing thoughts and I am delusional and paranoid.

Were you resistant to taking medication?

From the time I was ten years old, until I had Katherine, the therapists I saw recommended that I take medication, but I always resisted. I felt like I would be giving in, I didn't need medication, and I could do it on my own. I always thought things were bad, but I'd be ok. I thought I'd get over it. Now I realize that this is a chronic biological condition that I have to manage and requires medication.

What are the greatest challenges?

If I have a day where I'm not feeling great, I never know if it's the beginning of a slide. It's hard to gauge what is a normal fluctuation in mood. I get scared that I'm going to tank. Bill is great about reminding me that it's just a bad day. No matter how many times I go into a depression, there is an element of disordered thinking. I think, this time it's not going to end. I have this image of being alone in a forest, but I try to keep in mind that there are friends waiting for me at the edge. Eventually I'll find my way out again.

What is helpful for Bill to do?

He just needs to be there for me. I know he finds this hard to believe, because he doesn't think it helps, but it does.

What treatment issues have come up?

I struggle with the side effects of the mood stabilizer. It causes weight gain. It's frustrating because sometimes I wonder if not being able to control my weight is outweighing the benefit I receive from the medication

How do you motivate yourself?

I make a lot of lists. I know that if I have a schedule or routine of things to do, it helps me, even if it is really minimal.

Why do you speak out about your condition?

I never used to talk about it. When I went into the hospital, I had an amazing transformative experience. A woman came in who had attempted suicide. She didn't even have a room. She was on an IV, curled up in a fetal position. She was on suicide watch around the clock. Gradually, she started to get better. The first day that she was able to come to group therapy she sat right next to me. For some reason that day I opened up and started sobbing. The next thing I knew, I felt this hand on mine. This woman who had been so consumed in her own grief, was reaching out to me. Afterwards, I felt that if there is anything that I can do to help somebody understand, or get help, or change their mind about doing something rash, then I'm more than happy to help.

What are the greatest misconceptions people have?

People have a hard time understanding the difference between having a bad day or the blues that everyone goes through versus clinical depression. People say things well meaning, like 'I don't need a doctor, I have a best friend.' Or 'I just go out and have an ice cream.'

Bill

How did you react to Missy's hospitalization?

I was very upset when she went into the hospital. I didn't really understand what was going on. She seemed to be fine and then all of a sudden she was in the psych unit. I had never dealt with the idea that someone really close to me having psychological troubles. I'd thought about car accidents or traumas, but never something like this that I knew so little about.

I work as a pharmaceutical representative, so I'm interested in the medical field. In my job, I learned a lot about antidepressants and have wanted to help people get better. So, I read a lot of medical textbooks. I realized that depression is really hard to understand and deal with it. There is no simple solution.

How did you cope with Missy's condition?

I thought I dealt with it pretty well, but I did eventually develop a tic. I went to see a psychologist after a few years. The psychologist said, 'how long have you had this tic?' I said, 'what are you talking about?' I didn't know I had it. I tried to focus on taking care of Katherine. I made all the meals. Some days Missy would take care of her, other times I did it.

I was always analyzing the situation thinking 'how can I make this better?' I worried about whether her blood sugar was ok, if she had eaten a meal in the last few hours. I wondered whether she needed more exercise, or suffered from a lack of sunshine in the wintertime. I was always thinking there must be some way to fix this. I couldn't deal with the fact that it's a chronic, biological condition that has to be managed.

One difficulty is I could never predict what the next day was going to be like. I never knew if I was going to have a good day, or week, or month. The day could start out fine, but then I could get home from work and it would be terrible. If Missy is feeling terrible, then I'm on duty for the rest of the day. I wasn't upset that I was doing too much work; I was just so upset to see her in such a mess.

What were the worst points for you?

After the hospital, for at least four years, she was depressed most of the time. It was rough. We could be invited to someone's house and I'd say yes and then the time would come and I'd have to call and say we couldn't come. It was a mess. It was unpredictable and worrisome. Our relationship fell apart. I couldn't help but feel like there was something wrong with me that was making her depressed.

When she was depressed, she didn't have any love to give. She was very good with Katherine, but I knew she was acting. Then her reserve of energy was gone. So, we definitely drifted apart. The marriage suffered. Five or six years ago, I would have told you that there was no doubt that the marriage was not going to survive.

I would hold Missy's hand and give a hug, but I didn't get much emotion back. I started to feel I was useless and not able to help at all. I focused more on helping Katherine. I did feel angry at times because it was robbing me of my life, my right to enjoy myself.

What helped you?

A couple of things happened. Missy started getting better. Also, I was inept at talking about my feelings. We went to a couple's therapist and I learned to show more emotion and talk about my feelings. That brought us closer together. It's nice now; we're so much better.

What advice do you have?

Don't feel that you're part of the problem. Always remember that this is a biological condition, it's not because you're a bad spouse. Be supportive and loving and know that medication can make a huge difference. In a chronic situation, you should definitely see a specialist, a psychiatrist, not just a primary care physician. Primary care doctors are overwhelmed with new drugs coming out and there's no way that they can keep up with them all. Counseling is definitely helpful. Have hope. There is help out there. It is probably going to be a manageable situation.